Heartburn cost-effectiveness of therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: José Eduardo Riceto Loyola Junior, M.D.[2]
Overview
The use of proton pump inhibitors for 8 weeks associated with lifestyle modifications is a cost-saving strategy in patients with heartburn and gastroesophageal reflux disease (GERD).
Cost-effectiveness of Therapy
- A study from Stanford University School of Medicine revealed that "an 8-wk course of PPIs for initial symptom relief, followed by repeat courses of therapy initiated when symptoms recur, is more cost-effective than step-up or step-down strategies, or continuous therapy with either H2RAs or PPIs."[1]
- Costs estimated for the treatment of GERD according to the medication and regimen - considering mild GERD from 40yrs until death (in 1999 US dollars):
- Lifestyle - $0
- PPI-on-demand - $26,167
- H2RA-PPI - $27,846
- H2RA - $29,965
- Step down - $37,641
- PPI, continuous - $41,112
- Laparoscopic Nissen fundoplication (includes 2-day hospital stay) - approximately - $11,064.87
- Considering that the complications Barrett's esophagus may lead to esophageal cancer which presents with a much more costlier treatment, the on-demand PPI-therapy is the most cost-effective treatment available. The paper also stated that even thought it is the most cost-effective choice, it was the least used. The study was performed in 2000, which may cause its results to vary dramatically in more recent times.
References
- ↑ Gerson LB, Robbins AS, Garber A, Hornberger J, Triadafilopoulos G (2000). "A cost-effectiveness analysis of prescribing strategies in the management of gastroesophageal reflux disease". Am J Gastroenterol. 95 (2): 395–407. doi:10.1111/j.1572-0241.2000.01759.x. PMID 10685741.